Protecting Your Business

When it comes to knowing where your money is, there’s no room for speculation. Our claims analysis team regularly performs payor validation and internal control functions so you always know what’s going on with your money. Our routine audits and real-time, periodic validation processes provide a reliable safety net that identifies anything out of the ordinary and can be resolved before something goes wrong. It’s a fail-safe system that we’ve developed and refined over the course of decades, and it’s the best way to protect your business.

  • Perform payor validation and internal control functions with our unique verification process to monitor your practice for deviations in payor patterns, irregularities in payor payment schedules, and other areas
    • If discrepancies are identified, each issue is addressed with the payor for resolution and corrected adjudication per your contracted fee schedule
  • We audit 100% of the procedures that you perform to confirmĀ all billable procedures have been received and processed
    • After system integrity is validated, continuous routine and systematic audits are performed to detect any irregularities
  • Electronic Transfer Monitoring logs are received and reviewed daily and compared to relative expected volumes for the transfer date
    • Irregularities are investigated and resolved
  • Our coding team monitors the actual volume by date of service on a daily basis to identify any anomalies, comparing the actual volume received to the relative expected volume on that particular day of the week
    • If irregularities are identified, they are investigated and resolved
  • Modality Volume Trend Reports identify more subtle standard deviations in daily volumes and volumes by modality
  • Monthly Reconciliation involves independent electronic audits of each facility that you serve
    • Actual exams in our billing system are compared to the exams that the facility reports you performed
    • Provides a more exact audit trail